Queensland v Masson

The High Court of Australia heard an appeal from the Queensland Court of Appeal concerning a claim in negligence against the State of Queensland for the treatment of Jennifer Masson, who suffered severe, irreversible brain damage during an asthma attack. The dispute centred on the decision by an intensive care paramedic, Clinton Peters, to administer intravenous salbutamol rather than intravenous adrenaline as the initial treatment, despite Ms Masson being categorised as "imminent arrest" under the Queensland Ambulance Service's Clinical Practice Manual (CPM). Ms Masson's estate alleged that this failure to administer adrenaline promptly constituted a negligent omission for which the State was vicariously liable.

The legal issues before the High Court included whether the paramedic's decision to administer salbutamol instead of adrenaline was contrary to the CPM, whether the treatment fell below the standard of care expected of an ordinary skilled intensive care paramedic, and whether the trial judge's finding that the paramedic exercised clinical judgment was demonstrably wrong. Specifically, the court had to consider whether the CPM's guidance to "consider adrenaline" for patients in the "imminent arrest" category was determinative, or if it allowed for the exercise of clinical judgment, and whether the paramedic's choice of salbutamol was supported by a responsible body of medical opinion.

The High Court allowed the appeal, setting aside the orders of the Queensland Court of Appeal. The Court reasoned that intensive care paramedics are expected to exercise clinical judgment in applying the guidance in the CPM, and that the manual's terms were not determinative of the range of reasonable responses. The trial judge had found that the paramedic made a clinical judgment to administer salbutamol due to Ms Masson's high heart rate and blood pressure, and that this judgment was supported by a responsible body of medical opinion at the time. The High Court found that the Court of Appeal erred in overturning this finding, particularly by relying on a witness statement prepared seven years after the event and by giving undue weight to the timing of drug effects without sufficient consideration of the evidence presented at trial. The Court concluded that the paramedic's actions did not fall below the required standard of care.